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Job Location: Pune
Essential functions
Analyze data files, data layouts and data dictionaries from providers of health care administrative data (eligibility, account/plan, medical claims, pharmacy claims) to understand data structure and operating rules for transforming to common data format
Conduct in-depth interviews with data providers (client or payer staff) to ensure comprehensive understanding of data operating logic and data provided
Author data mapping and transformation requirements based on understanding of operating rules; review with ETL developers to ensure understanding
Produce detailed data quality profiles from client health care administrative data to validate structure, content and overall data quality; present findings to internal stakeholders for signoff and/or escalate critical data issues as necessary
Serve as subject matter expert in primary data domain relative to client’s data and transformation rules; back up analysts in other data domains as workloads and priorities necessitate
Execute test cases to validate source data has been accurately mapped, transformed and loaded to common format
Collaborate with data warehouse QA team to ensure seamless execution of test cases end-to-end
Alert project managers to potential risks and issues of importance
Academic Qualification
5+ years of experience in information technology
Bachelor’s Degree required
SQL skills to write queries, join tables to view/test data in a relational database
Understanding of Medical Claims, Rx Claims, Eligibility/Membership, healthcare insurance benefit and group account setup, Provider data and related processes around them
Proven track record in establishing strong relationships with internal stakeholders, clients and vendors
Very good oral and written communication skills
Preferred
Patience and persistence to sift through complex data/information to get to the core knowledge
Experience with clinical coding systems: ICD9 diagnosis codes, ICD9 procedure codes, CPT codes, revenue codes, provider NPI codes, NDC Rx codes.
Knowledge of medical claim file contents (both UB04 and HCFA-1500) and significance of individual fields
Experience testing data and creating related test cases
Intense intellectual curiosity and an ability to view problems with a fresh perspective
Excellent written computer and oral communication skills
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